Abstract

The objectives of e-STAR Romania (NCT00283517) were to collect clinical outcome data of Romania schizophrenia or schizo-affective disorder patients; prospectively to assess the reasons of treatment initiation, medication usage patterns; to document (long-term) clinical efficacy; and to collect safety data, as well as recording 2-year corresponding retrospective data. In total, 378 eligible subjects were enrolled who were initiated either on risperidone long-acting injectable (RLAI) (290) or on an oral antipsychotic (OA) (88) at baseline as required by the local Summary of the Product Characteristics. Data were collected from per patient both retrospectively and prospectively over a 24-month period at 3-month intervals after starting treatment. The results indicated that subjects suffering from schizophrenia or schizo-affective disorder initiated on RLAI were less likely to be hospitalized within the first 24 months after the initiation of treatment. Moreover, subjects treated with RLAI experienced significant improvements in their illness severity and functioning. Discontinuation rates for RLAI were low and doses were stable throughout the 24 months following the initiation of treatment. In addition, the necessity for supplementary concomitant medication was reduced. Adverse events were reported in 20.3% (RLAI) and 11.4% (OA) of the subjects. In general, patients initiated on RLAI and OA at baseline both clinically improved on all assessed parameters but a larger improvement was observed for patients on RLAI. Incidences of reported AEs during the use of RLAI in a naturalistic setting are comparable with those described in clinical studies; however, the incidence of extrapyramidal signs and weight gain was lower than expected.

Highlights

  • There are different opinions regarding the course of schizophrenia: it can be considered a deteriorative disease as the initial observation [1], but it has been described the pattern of multiple episodes [2], or the currently accepted relapsing course [3] [4]

  • Comparisons between retrospective and prospective data and between data from subjects who started on risperidone long-acting injectable (RLAI) or oral antipsychotic (OA) at baseline were made by means of appropriate statistical tests and executed using SAS® version 9.1.3 [SAS Institute, Cary, NC, USA] and were two-sided with a significance level of 0.05

  • As in the group of subjects who were initiated on RLAI at baseline, the majority of AEs were events coded as psychiatric disorders (6.8%)

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Summary

Introduction

There are different opinions regarding the course of schizophrenia: it can be considered a deteriorative disease as the initial observation [1], but it has been described the pattern of multiple episodes [2], or the currently accepted relapsing course [3] [4]. There is scarce information regarding the real prevalence and evolution of schizophrenia due to few epidemiological studies and long term naturalistic observational studies employ diverse research methods. Some of these facts have been recognized on an international level as barriers against appropriate, prompt diagnosis, and coherent monitoring. The utilization of hospital admittance records for research and administrative purposes as indicator of the passive epidemiology for the incidence and prevalence of schizophrenia relies on the assumption that the majority of schizophrenia ill persons will be hospitalized at least once in a life-time as a result of this illness [11]. These data do not reflect accurately the prevalence of schizophrenia in the general population for various reasons; up to 25% of schizophrenia patients received care only as outpatients [13] and 6.7% of ambulatory treated patients in a given catchment area had no hospitalizations [14]

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